Breast Cancer Awareness
Karla L. Robinson, MD
October is Breast Cancer Awareness month, so it is only appropriate to review this subject as it hits close to home for so many of us. Statistically, African American women are less likely to be diagnosed with breast cancer, but we are more likely to die from it.
It is thought that perhaps we have more advanced stages of the disease at the time of diagnosis.
This may be due to a lack of access to medical care and regular preventive screenings such as mammograms and breast exams. The American Cancer Society guidelines currently state:
*Mammography screening should begin for each woman of average risk at age 40, and yearly thereafter.
*Clinical breast exams by a physician are recommended every three years for women aged 20-39, and every year in women 40 years old and older.
This is in stark contrast to the U.S. Preventive Services Task Force which controversially recommended against yearly mammogram screening in women until the age of 50, and every two years thereafter. Most clinicians agree that this delayed recommendation for screening could be missing a vast number of women that could be diagnosed with breast cancer at an early stage. This is particularly true for African American women.
An estimated 1/3 of African American women with breast cancer are younger than age 50.
Unfortunately, African American women are also affected by more aggressive types of breast cancer.
Research is ongoing to determine why our cancers seem to be so deadly, and unresponsive to many conventional treatments. Preliminary studies show that the tumor cells in African American women with breast cancer grow at an alarmingly high rate as compared to other groups. Approximately 20-30% of breast cancers in African American women have also been found to be “Triple Negative”. This means that three of the conventional means used to treat breast cancer will not work to decrease the cancer load in these instances. Triple Negative breast cancers don’t have hormone receptors for estrogen, progesterone, or HER-2. Some breast cancer treatments are most effective by either blocking estrogen and progesterone from reaching the cancer cells, or by blocking tumor growth directly (HER-2). But, in “Triple Negative” cancers, these treatments are ineffective. Studies are now focusing on genetics for alternative treatment options.
Five year survival rates are astonishing. African American women have a five-year breast cancer survival rate of 69%, compared to that of 84% in white women. Some encouraging studies have shown that excluding the cases of the more aggressive types of breast cancer, African American women with regular, screening mammograms have similar survival rates as all other women! We have to do our part and participate in regular screening mammograms before a problem arises.
There may soon be a change in screening guidelines for African American women as more evidence is surfacing that up to 10% of our women with breast cancer were already diagnosed by age 40. There are some researchers now pushing for screening mammography in African American women as early as age 35. Regardless of the current screening recommendations, as African American women, we have to be aware of any changes in our bodies. Know your breasts. If there are any changes in them, you should be the first to know. If there is anything that you just aren’t sure about, go see your doctor.
If you have a family history of breast cancer, please consult with your doctor because your screening may need to start even earlier.
With October being Breast Cancer Awareness Month, make it a priority to have your regular breast cancer screening:
*If you are a woman in your 20s or 30s, you should be having clinical breast exams at the very least.
*For those women aged 40 and older, you must get your yearly mammogram.
There are many resources now in every state to help women get access to mammography screening. There are programs in your area that cover the cost of a mammogram when your insurance doesn’t.
Check out this list of resources in the Charlotte, NC metro area: http://www.urbanhousecallmagazine.com/greater-charlotte-nc-breast-cancer-screening-resources/
If you need more information, contact the American Cancer Society at 1-800-ACS-2345.